Objectives: To assess receipt of annual flu immunization among children living with sickle cell disease (SCD).

Methods: Receipt of flu immunization (2014-2019) by SCD status was assessed among all Michigan children <18 years of age using the statewide immunization registry. Logistic regression was used to estimate the odds of annual flu immunization by SCD status and age.

Results: Annual flu immunization coverage was higher among children with SCD (46.9%; n = 751) than without (23.2%; n = 2,012,846). The annual adjusted odds of flu immunization for those with SCD were 2.8 (95% CI: 2.5-3.1) times higher than for those without SCD; there were no significant differences by age among children with SCD. Among those without SCD, adolescents aged 13-17 were 2.2 (95% CI: 2.2-2.2) times less likely to receive annual flu immunization than children 6-35 months.

Conclusions: Children with SCD had higher annual flu immunization rates than those without SCD, but >50% remain unimmunized.